ArticleJournal of gastroenterology2023
Management of colorectal high-grade dysplasia or cancer resected by cold snare polypectomy: a multicenter exploratory study.
Article in Journal of gastroenterology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 5 citations in OpenAlex.
- Successful Salvage Underwater Endoscopic Mucosal Resection for Early Colorectal Cancer with Unclear Horizontal and Vertical Margin after Cold Snare Polypectomy: Two Case Reports.Journal of the anus, rectum and colon · 2026Article
- Depth of noninjecting resection using bipolar soft coagulation mode for 6 to 9 mm colorectal polyps: a retrospective study in Japan.Clinical endoscopy · 2026Article
- Evaluating the accuracy of preoperative endoscopic localization for colorectal cancer: post hoc analysis of a prospective study.Surgical endoscopy · 2025Observational
- Verification of the increase in concomitant dysplasia and cancer with the size of sessile serrated lesions.Endoscopy international open · 2024Article
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Authors and funding
25 authors at 20 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe clinical course and surveillance strategy for patients who undergo cold snare polypectomy (CSP) for high-grade dysplasia (HGD) or cancer is unclear. We investigated the management of colorectal HGDs and cancers following CSP.
methodsThis Japanese nationwide multicenter exploratory study was retrospectively conducted on patients who had undergone CSP for colorectal HGDs or cancers and follow-up colonoscopy at least once from 2014 to 2020. We investigated the detection rate of CSP scars, local recurrence rate (LRR), risk factors for local recurrence, and follow-up strategy. This study was registered with the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN000043670).
resultsWe included 155 patients with 156 lesions. CSP scars were identified in 22 (31.4%), 41 (54.7%), and 10 (90.9%) patients with curative, borderline, and non-curative resection, respectively. Among them, residual tumors were observed in one (4.5%), six (14.6%), and three (30.0%) cases, respectively. The total LRR was 13.7% (95% confidence interval: 6.8-23.8). R1 resection cases (either horizontal or vertical margins positive for tumors) were associated with local recurrence (p = 0.031). Salvage endoscopic and surgical resections were performed on 21 and 10 patients, respectively. Among them, the proportion of endoscopically suspected residual tumors was significantly higher (p < 0.001) in the residual tumor-positive group (100%) than in the residual tumor-negative group (28.6%).
conclusionsLRR after CSP for HGDs or cancers was 13.7% based on scar-identified cases. Salvage endoscopic or surgical resection should be performed according to the curability of the lesion and endoscopic findings during colonoscopic surveillance.
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